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36 Cards in this Set
- Front
- Back
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Assist control vent |
Set TV, set #/min. IE 500 tv, 12 bpm. |
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Synchronized vent (SIMV) |
Set total tidal volume set # per min. IE you breath 20 bmp at 200 tv. Machine covers deficit to set tidal 12 bmp. Remaining 8 respers are still at 200 tv. |
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High pressure alarm: causes |
Secretion. Coughing. Gag reflex. Patient breathing over or fighting vent. Water in tubing. Kinked hose. Bronchospasm. Decreased lung compliance. |
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Low pressure alarms |
Total or partial disconnect. Loss of airway. Cuff leak. |
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Apnea alarm |
Respiratory arrest. Oversedation. Change in pt condition. Loss of airway. |
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PEEP |
Creates positive pressure at end of ventilation restoring functional residual capacity |
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CPAP |
Restores FRC. Pressure is continuous during spontaneous respers. not used in patients with myocardial compromise since it increases work of expiration. |
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Bi-PAP |
Provides higher INSPIRATORY pressure and lower EXPIRATORY pressure along with o2. Delivered v face mask. Not used in pt with shock, altered mental stats, or thick secretions. |
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Causes of CLOSED pneumothorax |
Mechanical vent (barotrauma), venous cath, perforation of esophagus, broken ribs, COPD, or blunt trauma. |
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Causes of OPEN pneumothorax |
GSW or penetrating wound. |
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Tension pneumothorax |
May result from open or closed pneumothorax. Rapid accumulation of air in pleural cavity causing shinking of lung. AIR DOES NOT ESCAPE! |
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Blebs |
Result of airway inflammation commonly due to smoking. Found in spontaneous pneumothorax. |
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Risks for spontaneous pneumothorax. |
Male, smoker, COPD, fam hx, previous spontaneous pneumothorax. |
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Pneumothroax s&s |
Dyspnea, resp distress, cough, potential hemoptysis, cyanosis, tracheal deviation, audible air escaping (open), decreased breath sounds on side of injury, decrease o2 sat, frothy secretions. Tachycardia, thready pulse, decreased BP, narrow pulse pressure, asymmetric BP in BUE, JVD, chest pain, crunching sound synchronous with heart sounds, dysrhythmia. Brusing (blunt), abrasions (blunt), open wound (open), asymmetric chest expansion, subcutaneous emphysema |
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Pneumothorax interventions |
Ensure airway! Apply o2. 2 large bore IVs. Remove clothing to assess injury. cover sucking chest wound with nonporous dressing taped x3sides. Stabilize impaled object if present. DO NOT REMOVE PENETRATING OBJECT! Assess for significant injuries and treat appropriately. Stabilize flail ribs if present with hand until tape can be applied to stabilize area. Position in semi fowlers or ON affected side after ruling out SCI. monitor vitals. Prepare to intubate. Release dressing if tension pneumo forms. |
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Hemothorax |
Blood in pleural space. Dyspnea. Dimished breath sounds. Dull percussion. Decrease hgb. Potential for shock. |
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Tx hemothorax |
Insert chest tube with drain. Autotransfusion of collected blood. Treat hypovolemia PRN. |
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Tension pneumothorax s&s |
Cyanosis. Air hunger. Violent agitation. Tach deviation away from affected side. Sub q emphysema. Jvd. Hyperresonance. |
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Tx tension pneumothorax |
MED EMERGENCY! Needle decompression followed by chest tube |
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S&s flail chest |
Paradoxic chest wall movement. Resp distress. Hemo/pneumo thorax. Pulmonary contusion. |
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Tx flail chest |
O2. Analgesia. Stabilize flail with CPAP or Bi-PAP. Intubation. Treat injuries. |
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S&s cardiac tamponade |
Muffled distant heart sounds. Hypotension. Jvd. Increased cvp. |
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Tx of cardiac tamponade |
MED EMERGENCY! Pericardiocentesis with surgical repair. |
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Purpose of chest tube |
To remove air and fluid from around lung. |
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Tidaling |
Water inside suction device moves up and down with inhalation indicating patency. |
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Intermittent bubbling in water seal |
Indicates inspiration. Good thing. |
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Constant bubbling in water seal |
Indicates air leak |
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Lack of tidaling |
Indicates kinked tube, obstruction, or resolution of pneumothorax. |
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If drainage system breaks |
Place distal end of drain tube in 2 cm sterile water to create emergency water seal. |
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Measuring drainage |
Mark time and amount on drainage unit |
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Do you clamp to transport? |
No |
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Dressing for chest tube |
Occlusive with petroleum. Prevents air from bubbling out of dressing. |
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Solid organs |
Liver. Spleen, pancreas, spleen. Lots f blood |
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Hollow organs |
Stomach, bladder, intestines. Lead to peritonitis or sepsis. |
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Clinical manifestations of ABD trauma |
Guarding. Distended or hard abd. Decreased or absend bowel sounds. Bruising. Contusions. Pain. Hematemesis or hematuria. Hypovolemic shock. |
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Dx studies |
Cbc may be normal at first. Urinalysis to assess hematuria. Bun and creatinine. Ck to assess damage. |
